BACKGROUND About 5% of prostate cancer patients have distant metastases at diagnosis. In these metastatic hormone-sensitive prostate cancers (mHSPC), systemic therapy is recommended, according to the guidelines. Moreover, metastasis-directed therapy (MDT) is discussed to prolong survival. OBJECTIVES The contemporary literature concerning local therapy and MDT in patients with mHSPC is summarized. METHODS Selective literature search. RESULTS In 2018, randomized controlled data on local therapy in mHSPC patients were published by the authors of the STAMPEDE study. Here, patients were randomized between standard of care (SOC)?±?radiotherapy to the prostate (RT). Within the overall cohort, no difference regarding 3?year overall survival (OS) was observed. Within a&nbsp;prespecified subgroup of patients with low metastatic burden. Similar results were observed in numerous retrospective studies analyzing radical prostatectomy; prospective randomized studies are pending. For MDT, there are no sufficient data in mHSPC patients yet. CONCLUSIONS In the current guidelines, systematic therapy is standard of care in mHSPC patients. In patients with low metastatic burden, a&nbsp;survival benefit was observed when adding percutaneous RT to the prostate. Retrospective studies also suggest a&nbsp;benefit when adding RP. However, whether MDT prolongs survival is still unknown.BACKGROUND For many decades metastatic, castration-resistant prostate cancer (mCRPC) was thought to be treatment inaccessible. However, today, five drugs with significant life-prolonging effects are available in Germany, namely abiraterone, enzalutamide, docetaxel, cabazitaxel and radium-223. OBJECTIVE The different treatment strategies in mCRPC are reviewed. MATERIALS AND METHODS Landmark trials with supplementary information from Medline and abstracts of international congresses (ASCO; ASCO GU, ESMO) are summarized. RESULTS The androgen receptor (AR)-targeting agents abiraterone and enzalutamide significantly prolong overall survival before and after docetaxel therapy. In addition, cabazitaxel can be applied secondary to docetaxel. Due to the low affinity of cabazitaxel to p?glycoprotein it remains active even if docetaxel has failed. The α?emitter radium-223 can be considered in third line therapy for symptomatic patients with bone limited disease only. In patients with castration resistance, a&nbsp;short prostate-specific antigen (PSA) doubling time but without metastases in conventional imaging apalutamide, darolutamide and enzalutamide significantly prolong metastasis-free survival. DISCUSSION Prostate-specific membrane antigen (PSMA)-ligand therapy and novel targeting agents such as PARP inhibitors are promising new therapeutic modalities for mCRPC. Combination treatment strategies with immunotherapy are currently being evaluated in clinical trials. Based on the results of molecular analyses of tumor tissue as well as of circulating tumor cells and DNA, treatment of prostate cancer will be increasingly personalized in the future.Mind-body medicine (MBM) is based on the assumption that interactions between the brain, mind, body, and behavior can be used to activate health-promoting pathways towards better health. It includes behavioral medical approaches and techniques in conjunction with exercise, relaxation, stress regulation, and nutrition. MBM and MBM interventions are well-established in the US healthcare system. This also includes an exploration of their underlying mechanisms. In Germany, too, a&nbsp;growing body of interventions are now summarized under this generic term.In this narrative review, the emergence of MBM is illuminated in the context of historical developments as well as against the background of the meditation research that has been emerging since the 1970s and the investigation of the stress phenomenon. References to basic research including neurobiological reward/placebo physiology are presented. Distinctions to psychotherapy are made and an implementation framework is described.MBM is related to health promotion and the therapy of chronic, especially lifestyle-related diseases. It is based on the salutogenesis approach, i.e., a&nbsp;paradigm that seeks to explore and reinforce health determinants and resistance resources (individual resilience and coherence factors) and strives to reduce stress. This approach corresponds to self-healing or self-care principles. Neurobiologically, it is associated with the placebo effect. MBM interventions typically follow the BERN model (behavior-exercise-relaxation-nutrition).As a&nbsp;facilitator of self-healing and self-care, MBM can be professionally trained and empowered. For doing so, "health promotion experts" are used.BACKGROUND Since long travel times to reach health facilities are associated with worse outcomes, geographic accessibility is one of the six core global surgery indicators; this corresponds to the second of the "Three Delays Framework," namely "delay in reaching a health facility." Most attempts to estimate this indicator have been based on geographical information systems (GIS) algorithms. The aim of our study was to compare GIS derived estimates to self-reported travel times for patients traveling to a district hospital in rural Rwanda for emergency obstetric care. METHODS Our study includes 664 women who traveled to undergo a Cesarean delivery in Kirehe, Rwanda. We compared self-reported travel time from home to the hospital (excluding waiting time) with GIS estimated travel times, which were computed using the World Health Organization tool AccessMod, using linear regression. RESULTS The majority of patients used multiple modes of transportation (walking?=?48.5%, public transport?=?74.2%, private transport?=?2.9%, and ambulance 70.6%). Self-reported times were longer than GIS estimates by a factor of 1.49 (95% CI 1.40-1.57). Concordance was higher when the GIS model took into account that all patients in Rwanda are referred via their health center (β?=?1.12; 95% CI 1.05-1.18). CONCLUSIONS To our knowledge, in this largest to date GIS validation study for geographical access to healthcare in low- and middle-income countries, a standard GIS model was found to significantly underestimate real travel time, which likely is in part because it does not model the actual route patients are travelling. https://www.selleckchem.com/products/nf-kb-activator-1.html Therefore, previous studies of 2-h access to surgery will need to be interpreted with caution, and future studies should take local travelling conditions into account.